Increased risk of preterm birth among women with mitral valve prolapse: a nationwide, population-based study.

PURPOSE

Using nationwide population-based databases, we aimed to assess the association between mitral valve prolapse (MVP) and adverse pregnancy outcomes.

METHODS

The Taiwan Birth Registry and the National Health Insurance Research Dataset were used for analysis. Of all pregnant women in Taiwan who had singleton births in 2005, we identified a total of 3104 mothers diagnosed with MVP during ambulatory or emergency care visits, together with 12,245 mothers unaffected by MPV. Multivariate logistic regression was performed.

RESULTS

Multivariate logistic regressions showed that, compared with unaffected mothers, the adjusted odds ratios of preterm birth and cesarean section for mothers with MVP were 1.27 (95% confidence interval [CI], 1.10-1.48) and 1.34 (95% CI, 1.20-1.50), respectively. In further stratification based on the timing of the MVP diagnosis, the highest risks of preterm birth were observed for mothers diagnosed with MVP during (but not before) pregnancy (odds ratio [OR], 1.54; p = .001). No significant difference was observed between women with and without MVP for other outcomes such as low birthweight, intrapartum complications, low Apgar scores, and congenital malformations.

CONCLUSIONS

Our study found a significant risk of preterm delivery among women with MVP. A multidisciplinary team approach to providing obstetric care, with the mission of monitoring signs of cardiac complications and preterm birth, is imperative.